MEDICARE: BRANDON SNYDER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT019296	PA

General Provider Information

NPI Number	:	1922269919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON SNYDER DPT

Provider Business Mailing Address
First Line	:	39 PORTER RD STE 1
Second Line	:
City	:	TOWER CITY
State	:	PA
Zip	:	17980-9457
Country	:	US
Telephone Number	:	717-523-2502
Fax Number	:	717-523-2503

Provider Business Practice Location Address
First Line	:	39 PORTER RD STE 1
Second Line	:
City	:	TOWER CITY
State	:	PA
Zip	:	17980-9457
Country	:	US
Telephone Number	:	717-523-2502
Fax Number	:	717-523-2503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	10/01/2019

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